The Californer - Foster Care Children Vulnerable to Maltreatment, Including Psychotropic Drug Use

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OIG report highlights failed foster care oversight

CCHR, a mental health industry watchdog, praises OIG report
highlighting states' failed oversight of foster children's treatment and calls for immediate action to address ongoing drugging concerns.

LOS ANGELES - Californer -- The Office of the Inspector General (OIG) under the U.S. Department of Health and Human Services delivered a critical report on the inadequate protection of foster care children in residential behavioral treatment centers. The Citizens Commission on Human Rights International (CCHR), which has long exposed the mistreatment and psychotropic drugging of foster children, commended the OIG report titled "Many States Lack Information To Monitor Maltreatment in Residential Facilities for Children in Foster Care."[1] CCHR emphasized the report's candid assessment of the poor state of oversight and stressed the urgency of implementing its recommendations to prevent the failures of past reform efforts.

The report says, "Policymakers, news media, and advocacy groups have raised concerns about the effectiveness of oversight efforts to protect children in these settings." It surveyed each state child welfare agency to determine how they monitor child maltreatment that occurs in residential facilities. This is because "States oversee residential facilities, and ACF [Administration for Children and Families] provides funding and oversight to States for children in foster care who meet certain eligibility requirements."

The OIG's findings show a failure to meet these requirements. Nearly one-third of states could not identify patterns of maltreatment in residential facilities within their state. States also had limited awareness of maltreatment that occurred across chains of residential facilities operating in multiple states.

Instances of abuse and neglect (collectively referred to as maltreatment) have been reported as occurring in residential facilities, including cases of physical violence, sexual assault, and improper restraints across nationwide chains of facilities.

CCHR filed Freedom of Information Act requests to each state asking for the numbers of Medicaid/Children's Health Insurance Program (CHIP) child beneficiaries who were drugged in 2023. To date, 28 states have responded, revealing that 2.3 million underprivileged children and teens ages 0-17 were prescribed psychiatric drugs under Medicaid at a cost of $1.4 billion.

Stimulants are the predominant class of psychiatric drugs prescribed to them, followed by anti-anxiety drugs for 0-5 year-olds, both of which are documented to cause addiction and other dangerous adverse effects.

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In 2011, the U.S. Government Accounting Office (GAO) found that foster children aged 0-17 in Medicaid were drugged at rates 2.7-4.5 times higher than were non-foster children in Medicaid. A sample of five states revealed the following percentages of foster children on psychotropic drugs:

Massachusetts 39.1%
Texas 32.2%.
Florida 22%,
Michigan 21%,
Oregon 19.7%[2]

While the two statistics are not comparable data, CCHR's FOIA requests indicated:

Florida: 185,428 0-17 year-olds (at a cost of $178.45 million), of which 18,938 were 0-5 years old (with drug costs of $2.78 million)
Michigan: 100,364 0-17 year-olds ($73.37 million), of which 6,839 were 0-5 ($2.27 million)
Massachusetts 59,169 0-17 year-olds ($68.81 million) of which 1,890 were ages 0-5 ($557,827)

Oregon and Texas have not yet provided statistics, but the Texas, "Update on the Use of Psychotropic Medications for Children in Texas Foster Care: State Fiscal Years 2002-2022 Data Report" reported that in 2022, 21.4% (11,160) of 0-17 year old foster children were still receiving psychiatric drugs, of which, 2% (300) were ages 0-2.

CCHR lists some of the past government findings regarding this:

2008-2010: The Congressional Research Service found that nearly one out of every four children in foster care was using a psychiatric drug.[3]

2011: The GAO determined that the federal government had not done enough to oversee the treatment of foster children with powerful mind-altering drugs.[4]

ABC News' story, "Generation Meds," revealed foster children were more than nine times more likely than non-foster children to be prescribed drugs for which there was no FDA-recommended dose for their age.[5] Diane Sawyer and Sharyn Alfonsi uncovered that many foster children, even one-year-olds, were prescribed mind-altering drugs up to 13 times higher than that of other children.[6]

2012: Senator Charles Grassley sent letters to 34 states asking what steps they had taken to investigate doctors whose prescribing of antipsychotics, anti-anxiety drugs and painkillers to Medicaid patients far exceeded that of their peers.[7]

2014: A Congressional hearing acknowledged that at disproportionately higher rates over other children. The GAO estimated numbers as high as 20 to 39%.[8]

In a 2020 study published in Psychiatric Services, the effects of this reliance upon drugging were noted, "Psychoactive medications are the most expensive and fastest-growing class of pharmaceutical agents for children. The cost, side effects, and unprecedented growth rate at which these drugs are prescribed have raised alarms from health care clinicians, patient advocates, and agencies about the appropriateness of how these drugs are distributed to parents and their children."[9]

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CCHR wants accountable oversight of congregate mental health and behavioral facilities, especially identifying the drug and treatment practices that foster care and Medicaid/CHIP child beneficiaries receive, as well as isolating top prescribers. Tough penalties are needed for child maltreatment involving psychotropic drugs or other psychotherapeutic practices.

About CCHR: It was established in 1969 by the Church of Scientology and eminent professor of psychiatry, Dr. Thomas Szasz. Helping achieve hundreds of laws to protect individuals, the 2004 federal Prohibition of Mandatory Medication Amendment banned children from being forced to take psychiatric drugs as a requisite for education.

[1] "Many States Lack Information To Monitor Maltreatment in Residential Facilities for Children in Foster Care," June 2024, oig.hhs.gov/documents/evaluation/9920/OEI-07-22-00530.pdf

[2] Kelly O'Meara, "National Child Abuse Prevention Month: Stop Mass Drugging of Foster Care Kids," CCHR International, 28 Apr. 2015, www.cchrint.org/2015/04/28/national-child-abuse-prevention-month-stop-mass-drugging-of-foster-care-kids/

[3] Kelly O'Meara, "Congress Saying Foster Kids are 'Over-drugged' is Like Saying Nuclear Waste is 'Overly-toxic,'" CCHR International, 3 June 2014, www.cchrint.org/2014/06/03/congress-saying-foster-kids-are-over-drugged-is-like-saying-nuclear-waste-is-overly-toxic/

[4] "New Study Shows U.S. Government Fails to Oversee Treatment of Foster Children With Mind-Altering Drugs: GAO report released today caps off year-long investigation by ABC News," ABC News, 30 Nov. 2011, abcnews.go.com/US/study-shows-foster-children-high-rates-prescription-psychiatric/story?id=15058380

[5] "New Study Shows U.S. Government Fails to Oversee Treatment of Foster Children With Mind-Altering Drugs: GAO report released today caps off year-long investigation by ABC News," ABC News, 30 Nov. 2011, abcnews.go.com/US/study-shows-foster-children-high-rates-prescription-psychiatric/story?id=15058380

[6] "ABC News Investigation: Diane Sawyer and Sharyn Alfonsi to Report on the Overmedication of Children in the U.S. Foster Care System," ABC News, 20 Nov. 2011, abcnews.go.com/blogs/headlines/2011/11/abc-news-investigation-diane-sawyer-and-sharyn-alfonsi-to-report-on-the-overmedication-of-children-in-the-u-s-foster-care-system

[7] "Senate Watchdog Targets High-Prescribing Medicaid Docs," ProPublica, 24 Jan. 2012, www.propublica.org/article/senate-watchdog-targets-high-prescribing-medicaid-docs

[8] Kelly O'Meara, "Congress Saying Foster Kids are 'Over-drugged' is Like Saying Nuclear Waste is 'Overly-toxic,'" CCHR International, 3 June 2014, www.cchrint.org/2014/06/03/congress-saying-foster-kids-are-over-drugged-is-like-saying-nuclear-waste-is-overly-toxic/

[9] Kelly J. Kelleher, M.D., "Policy and Practice Innovations to Improve Prescribing of Psychoactive Medications for Children," Psychiatric Services, 19 Mar. 2020